鼻咽癌调强放疗和常规放疗剂量分析

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1、中文摘要2IMRT中剂量跌落急剧，有可能造成边缘区复发，有待于进一步规范照射范围和不同部位的剂量，在提高疗效的同时，进一步降低并发症的发生率，提高患者的生存质量。关键词：鼻咽癌；放疗；调强放疗；常规放疗；剂量英文摘要DoseanalysisoftheIntensity—modulatedradiotherapyandConventionaltwo．．dimensionalradiotherapyforNasopharyngealCancerABSTRACTObjective：Toanalyzethedifferenceofthedosedistributionbet

2、weentheIMRTplansandthe2DCRTplansinthetreatmentplanningsystemthroughsimulatingthe2DCRTplansandIMRTplans，furtherprovidingtheassistanceforclinicalpractice．Methods：FromJune2012toJanuary2013，15patientswimnasopharyngealcarcinomareceivedIMRTintheBeijingMilitaryRegionGeneralHospital．Thetargeta

3、reaoftheIMRTrequirementwasinaccordancewiththe¨nasopharyngealcarcinomaafterradiotherapyofheadandneckcanceratlas--secondedition’’and2DCRTfaciocervicalportalandshrinkingfieldweresimulatedonDRR．DesigningtheIMRTplansandsimulatingthe2DCRTplansontheDRRfor15NPCwiththePinnacle39．2ftreatmentplan

4、ningsystem，respectively,eachpatienthavetwosetsofplansandDosecurvefigures．ThencomparetheDoseinIMRTand2DCRTplans．The2DCRTplan：inthefirststage，two-sidedfaciocervicalportalfield+anteriortangentialfieldoftheunderneck36Gy．Inthesecondphase，two-sidedshrinkingfaciocervicalportalfield(occlusions

5、pinalcord)+thebilateralbackneckareaelectronicfieldof24Gy+underanteriortangentfield14Gy．Iftheneckhadpositivelymphnodes，irridatethenodetilltotal70Gyusingelectronicenergy．Thirdly,completetheamountof10GybinauralofMaeno4-neckelectronicenergyforpositivelymphnodes10Gy．Basedonthecentralplane，n

6、asopharyngealtumorsandmetastaticlymphnodesreached70Gy,doublesideofthefaciocervicalandbackoftheneckareaupto60Gy,50Gylowernecksupraclaviculararea．IMRTplan：GTVnxisthetumorwhichCanbeseenintheImaging；GTVndismetastaticlymphnodes；GTVnxexpand20-30mmbackwards，and5mm-10mminotherdirectionstoform5

7、英文摘要pGTVnx．CTvlissubclinicallesions，includingnasopharynx，skullbase，retropharyngealspace，thelowerpartofthesphenoidsinus，thepterygomandibularfossa，nasalandthirdmaxillarysinusandhigh—risklymphaticmetastaticarea．CTV2istheneckpreventionirradiatedareas．PTVwasextrovertedfromCTVin3mm，andnear